Frontiers in Cardiovascular Medicine最新文献

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Protective effect of UDCA against IL-11- induced cardiac fibrosis is mediated by TGR5 signalling.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-12-03 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1430772
B Reilly-O'Donnell, E Ferraro, R Tikhomirov, R Nunez-Toldra, A Shchendrygina, L Patel, Y Wu, A L Mitchell, A Endo, L Adorini, R A Chowdhury, P K Srivastava, F S Ng, C Terracciano, C Williamson, J Gorelik
{"title":"Protective effect of UDCA against IL-11- induced cardiac fibrosis is mediated by TGR5 signalling.","authors":"B Reilly-O'Donnell, E Ferraro, R Tikhomirov, R Nunez-Toldra, A Shchendrygina, L Patel, Y Wu, A L Mitchell, A Endo, L Adorini, R A Chowdhury, P K Srivastava, F S Ng, C Terracciano, C Williamson, J Gorelik","doi":"10.3389/fcvm.2024.1430772","DOIUrl":"10.3389/fcvm.2024.1430772","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac fibrosis occurs in a wide range of cardiac diseases and is characterised by the transdifferentiation of cardiac fibroblasts into myofibroblasts these cells produce large quantities of extracellular matrix, resulting in myocardial scar. The profibrotic process is multi-factorial, meaning identification of effective treatments has been limited. The antifibrotic effect of the bile acid ursodeoxycholic acid (UDCA) is established in cases of liver fibrosis however its mechanism and role in cardiac fibrosis is less well understood.</p><p><strong>Methods: </strong>In this study, we used cellular models of cardiac fibrosis and living myocardial slices to characterise the macroscopic and cellular responses of the myocardium to UDCA treatment. We complemented this approach by conducting RNA-seq on cardiac fibroblasts isolated from dilated cardiomyopathy patients. This allowed us to gain insights into the mechanism of action and explore whether the IL-11 and TGFβ/WWP2 profibrotic networks are influenced by UDCA. Finally, we used fibroblasts from a TGR5 KO mouse to confirm the mechanism of action.</p><p><strong>Results and discussion: </strong>We found that UDCA reduced myofibroblast markers in rat and human fibroblasts and in living myocardial slices, indicating its antifibrotic action. Furthermore, we demonstrated that the treatment of UDCA successfully reversed the profibrotic IL-11 and TGFβ/WWP2 gene networks. We also show that TGR5 is the most highly expressed UDCA receptor in cardiac fibroblasts. Utilising cells isolated from a TGR5 knock-out mouse, we identified that the antifibrotic effect of UDCA is attenuated in the KO fibroblasts. This study combines cellular studies with RNA-seq and state-of-the-art living myocardial slices to offer new perspectives on cardiac fibrosis. Our data confirm that TGR5 agonists, such as UDCA, offer a unique pathway of action for the treatment of cardiac fibrosis. Medicines for cardiac fibrosis have been slow to clinic and have the potential to be used in the treatment of multiple cardiac diseases. UDCA is well tolerated in the treatment of other diseases, indicating it is an excellent candidate for further in-human trials.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1430772"},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Traditional Chinese medicine for cardiovascular disease: efficacy and safety.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-12-03 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1419169
Youwei Lin, Yuanshan Han, Yuhong Wang
{"title":"Traditional Chinese medicine for cardiovascular disease: efficacy and safety.","authors":"Youwei Lin, Yuanshan Han, Yuhong Wang","doi":"10.3389/fcvm.2024.1419169","DOIUrl":"10.3389/fcvm.2024.1419169","url":null,"abstract":"<p><p>In China and other Asian nations, traditional medicine has long been utilized in the treatment of cardiovascular diseases (CVD). While Chinese authorities have incorporated traditional Chinese medicine (TCM) treatment experiences as a supplementary guide for CVD, its international recognition remains limited due to a scarcity of high-quality and reliable randomized controlled trials (RCTs) evidence. The purpose of this study was to examine the clinical outcomes with TCM for CVD after the recent publication of large trials adding >20,000 individuals to the published data. Here, we systematically reviewed 55 published RCTs (modified Jadad scores > 4) in the past 20 years, involving a total of 36,261 patients. In most studies, TCM has been associated with significant improvements in alternative endpoints such as hypertension, coronary heart disease, stroke and heart failure. A total of 19 trials reported on primary outcomes such as cardiovascular events and death events. During the follow-up period, some Chinese patent medicines can effectively reduce the \"hard\" endpoints of coronary heart disease, stroke, and heart failure, the overall trend of cardiovascular outcomes is lower. The risk of adverse effects was not significantly increased compared to the control group, suggesting its potential as an alternative approach for primary and secondary prevention of CVD based on the available evidence.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1419169"},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlation between thrombocytopenia and adverse outcomes in patients with atrial fibrillation: a systematic review and meta-analysis.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-12-03 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1383470
Qiuhua Ding, Wenlin Xu, Yaoyao Chen, Sijie Chang, Jinhua Zhang
{"title":"Correlation between thrombocytopenia and adverse outcomes in patients with atrial fibrillation: a systematic review and meta-analysis.","authors":"Qiuhua Ding, Wenlin Xu, Yaoyao Chen, Sijie Chang, Jinhua Zhang","doi":"10.3389/fcvm.2024.1383470","DOIUrl":"10.3389/fcvm.2024.1383470","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia is often associated with adverse outcomes in patients with atrial fibrillation. Therefore, we conducted a meta-analysis to comprehensively assess the impact of thrombocytopenia on ischemic stroke/systemic embolism, major bleeding and all-cause mortality in patients with atrial fibrillation.</p><p><strong>Methods: </strong>Two electronic databases, PubMed and Web of Science, were systematically searched from their inception to December 1, 2023, including the studies on the correlation between atrial fibrillation patients with thrombocytopenia and adverse outcomes. Relevant data was extracted, literature quality was evaluated, meta-analysis was performed by using REVMAN 5.4 software, and the results were reported with odds ratio (OR) of 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 12 studies included 73,824 patients with atrial fibrillation (average age: 72.67, males: 42,275, 57.3%), among them, there were 7,673 patients combined with thrombocytopenia. The average follow-up time of these studies was 87 days to 55 months. Compared to no thrombocytopenia, atrial fibrillation patients combined with thrombocytopenia have a significant risk reduction of ischemic stroke/systemic embolism [OR: 0.79, 95% CI: (0.69, 0.91); <i>P</i> < 0.01]. Nevertheless, the risk of both major bleeding [OR: 1.51, 95% CI: (1.20, 1.79), <i>P</i> < 0.01] and all-cause mortality [OR: 1.40, 95% CI: (1.23, 1.61); <i>P</i> < 0.01] is significantly higher in thrombocytopenia group.</p><p><strong>Conclusions: </strong>Thrombocytopenia has an important impact on the prognosis of patients with atrial fibrillation. Thrombocytopenia is significantly associated with a lower risk of ischemic stroke/systemic embolism but a higher risk of major bleeding and all-cause mortality. Attention to thrombocytopenia and optimization of treatment may be the effective way to improve the prognosis of atrial fibrillation with thrombocytopenia.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/, PROSPERO Registration Number: (CRD42023459916).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1383470"},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Uncommon presentation of left main congenital coronary aneurysm: a rare case report.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-12-02 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1504835
Peng Xu, Shili Zhong, Hui Tan
{"title":"Uncommon presentation of left main congenital coronary aneurysm: a rare case report.","authors":"Peng Xu, Shili Zhong, Hui Tan","doi":"10.3389/fcvm.2024.1504835","DOIUrl":"10.3389/fcvm.2024.1504835","url":null,"abstract":"<p><p>Coronary aneurysm, a dilated segment of the coronary artery, is a rare condition with a prevalence ranging from 0.02% to 0.2%. According to the current literature, reports of large aneurysms in the left main artery are extremely rare. We present a case of a 43-year-old male patient presenting with cough, wheezing, and dyspnea after a cold. Initial examinations suggested viral myocarditis, but further evaluation revealed a giant aneurysm in the left main coronary artery. Due to the high surgical risk, conservative treatment was chosen. Follow-up assessments showed no significant changes in the coronary aneurysm, with slight improvement in dyspnea. This rare case of a left main congenital coronary aneurysm suggests that treatment should consider the patient's overall condition, thrombosis presence, suitability for anticoagulant therapy, and aneurysm location and size.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1504835"},"PeriodicalIF":2.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The function of miRNAs in the immune system's inflammatory reaction to heart failure. miRNA 在免疫系统对心力衰竭的炎症反应中的功能。
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-12-02 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1506836
Kadierya Yibulayin, Maidinaimu Abulizi
{"title":"The function of miRNAs in the immune system's inflammatory reaction to heart failure.","authors":"Kadierya Yibulayin, Maidinaimu Abulizi","doi":"10.3389/fcvm.2024.1506836","DOIUrl":"10.3389/fcvm.2024.1506836","url":null,"abstract":"<p><p>Heart failure is the end stage of cardiovascular disease, with high morbidity and mortality rates worldwide. Heart failure is associated with long-term and insufficient inhibition of inflammatory response. miRNA is a class of endogenous, non-coding, single-stranded small RNA molecules, that can regulate gene expression through translational inhibition or degradation of targeted mRNA, widely regulate myocardial remodeling, inflammatory response, and other pathological processes, and play an important regulatory role in the occurrence and development of cardiovascular diseases. This article reviews the role of miRNA in the inflammatory response in heart failure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1506836"},"PeriodicalIF":2.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Non-linear relationship between platelet count and 28-day mortality in critically ill patients with infective endocarditis: a retrospective cohort study from MIMIC IV database.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1458238
Yingxiu Huang, Ting Ao, Peng Zhen, Ming Hu
{"title":"Non-linear relationship between platelet count and 28-day mortality in critically ill patients with infective endocarditis: a retrospective cohort study from MIMIC IV database.","authors":"Yingxiu Huang, Ting Ao, Peng Zhen, Ming Hu","doi":"10.3389/fcvm.2024.1458238","DOIUrl":"10.3389/fcvm.2024.1458238","url":null,"abstract":"<p><strong>Background: </strong>The relationship between platelet count and 28-day mortality in critically ill patients with infective endocarditis (IE) is currently not well established.</p><p><strong>Objective: </strong>This study aims to investigate the impact of platelet count on 28-day mortality in critically ill patients with infective endocarditis.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 450 participants diagnosed with infective endocarditis and admitted to intensive care units (ICU). Vital signs, laboratory parameters and comorbidity were collected for all participants to analyze the association between platelet count and 28-day mortality. In order to assess the independent association between platelet count and 28-day mortality, we employed multivariable cox hazard regression analyses and smooth curve fitting. A further analysis was conducted using a two-piecewise linear regression model to examine the nonlinear association between platelet count and in-hospital mortality.</p><p><strong>Results: </strong>A total of 450 critically ill patients with infective endocarditis were included in the study. The mean age was 57.4 years, and 64.2% were male. The overall 28-day mortality rate was 20%. A non-linear relationship was observed between platelet count and 28-day mortality. Two different slopes were identified, with correlations between platelet count and 28-day mortality in patients with IE differing significantly below and above the inflection point, which was approximately 141 K/µl. On the left side of the inflection point, the hazard ratio was 0.990 (hazard ratio: 0.990, 95% confidence interval: 0.982-0.997, <i>p</i> = 0.006). However, on the right side of the inflection point, the hazard ratio increased marginally to 1.0004 (HR: 1.0004, 95% CI: 0.997-1.004, <i>p</i> = 0.825). Notably, the association lacked statistical significance on the right side of the inflection point.</p><p><strong>Conclusion: </strong>A nonlinear association between platelet count and 28-day mortality was observed in critically ill patients with infective endocarditis. The optimal platelet count associated with the lowest risk of 28-day mortality was above 141 k/µl.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1458238"},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heart-brain interactions: clinical evidence and mechanisms based on critical care medicine.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1483482
Chuyao Qi, Wenting Wang, Yanfei Liu, Tianfeng Hua, Min Yang, Yue Liu
{"title":"Heart-brain interactions: clinical evidence and mechanisms based on critical care medicine.","authors":"Chuyao Qi, Wenting Wang, Yanfei Liu, Tianfeng Hua, Min Yang, Yue Liu","doi":"10.3389/fcvm.2024.1483482","DOIUrl":"10.3389/fcvm.2024.1483482","url":null,"abstract":"<p><p>In this review paper, we search the recent literature regarding the application of the heart-brain interaction theories in the field of intensive care unit. Simultaneously, we methodically summarize the clinical evidence supporting its application in intensive care unit treatment, based on clinical randomized trials and clinical case studies. We delve into how it's applied in treating severely ill patients and in researching animal models for cardio-cerebral comorbidities, aiming to supply benchmarks for subsequent clinical trials and studies on mechanisms.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1483482"},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case Report: Anomalous origin of the right coronary artery leading to cardiac arrest induced by sexual activity: a previously unreported pathogenetic condition. 病例报告:右冠状动脉起源异常导致性活动诱发心脏骤停:一种以前从未报道过的病因。
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1414821
Junchu Tang, Da Li, Shuizhu Wang
{"title":"Case Report: Anomalous origin of the right coronary artery leading to cardiac arrest induced by sexual activity: a previously unreported pathogenetic condition.","authors":"Junchu Tang, Da Li, Shuizhu Wang","doi":"10.3389/fcvm.2024.1414821","DOIUrl":"10.3389/fcvm.2024.1414821","url":null,"abstract":"<p><strong>Background: </strong>The Anomalous Origin of the Right Coronary Artery from the Left Coronary Sinus (ARCA-LCS) is a rare congenital cardiac condition where the right coronary artery emerges from the left sinus instead of the right coronary sinus of Valsalva. The clinical significance of ARCA-LCS lies in its potential to cause myocardial ischemia or sudden cardiac death, particularly under physical exertion. In this case, a patient experienced sudden cardiac arrest during sexual activity, which has not previously been reported.</p><p><strong>Case presentation: </strong>Six years ago, a 37-year-old man was admitted with sudden cardiac arrest during sexual intercourse. No previous history of hypertension or diabetes. There was no abnormality in physical examination. Transthoracic echocardiogram, bilateral carotid Doppler ultrasound, and electrocardiogram were normal. Cranial magnetic resonance imaging and magnetic resonance angiography showed no abnormalities. A treadmill exercise test revealed ischemic changes. Coronary computed tomography angiography showed ARCA-LCS, and passage through the vessel wall between the aorta and pulmonary artery.</p><p><strong>Conclusion: </strong>This case illustrates a patient with asymptomatic ARCA-LCS for 37 years who did not receive appropriate treatment during a previous visit, but who subsequently experienced a serious cardiovascular event that demonstrated the potential harm of the disease. Therefore, timely intervention in patients with ARCA-LCS, especially in high-risk groups, is critical to prevent potentially catastrophic cardiovascular events. However, in the present case report, the patient did not experience a similar event during the 6-year follow-up by avoiding overexertion and changing his lifestyle at the time of previous onset of the disease. Further studies are needed to optimize diagnostic and therapeutic strategies for ARCA-LCS.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1414821"},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of patients undergoing protected high risk percutaneous coronary intervention using either intravascular lithotripsy or rotational atherectomy. 使用血管内碎石术或旋转动脉粥样硬化切除术对接受受保护的高风险经皮冠状动脉介入治疗的患者进行比较。
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1451229
Tobias T Krause, Shazia S Afzal, Anida Gjata, Michael Lindner, Louai Saad, Mirjam Steinbach, Rashad Zayat, Assad Haneya, Nikos Werner, Juergen Leick
{"title":"Comparison of patients undergoing protected high risk percutaneous coronary intervention using either intravascular lithotripsy or rotational atherectomy.","authors":"Tobias T Krause, Shazia S Afzal, Anida Gjata, Michael Lindner, Louai Saad, Mirjam Steinbach, Rashad Zayat, Assad Haneya, Nikos Werner, Juergen Leick","doi":"10.3389/fcvm.2024.1451229","DOIUrl":"10.3389/fcvm.2024.1451229","url":null,"abstract":"<p><strong>Background: </strong>Treating heavily calcified vessels is a challenging task in patients with an impaired left ventricular ejection fraction. Percutaneous mechanical circulatory support (pMCS) is increasingly used in patients in high-risk percutaneous coronary intervention (HRPCI).</p><p><strong>Methods: </strong>In this retrospective registry, we investigated 25 patients undergoing a protected HRPCI receiving either intravascular lithotripsy (IVL + pMCS; <i>n</i> = 11) or rotational atherectomy (RA + pMCS; <i>n</i> = 14). The primary endpoint was defined as peri-interventional hemodynamic stability. The secondary endpoint was defined as major adverse cardiac events (MACE).</p><p><strong>Results: </strong>Patients in the IVL + pMCS group had a significantly higher mean arterial pressure (MAP) at the end of the procedure (<i>p</i> = 0.04)<i>.</i> However, the Δ-change in MAP was not significant [-12 mmHg (±20.3) vs. -16.1 mmHg (±23.9), <i>p</i> = 0.709]. The proportion of patients requiring post-interventional catecholamines was significantly lower in the IVL + pMCS group (<i>p</i> = 0.02)<i>.</i> The Δ-change in Syntax Score was not significant between groups (IVL + pMCS -22 (±5.8) vs. RA + pMCS -21.2 (±7.6), <i>p</i> = 0.783). MACE did occur less in the group of IVL + pMCS (0% vs. 20%, <i>p</i> = 0.046). Patients with pMCS insertion as a bailout strategy had a higher probability for in-hospital death (<i>p</i> < 0.001) and the occurrence of the slow-reflow phenomenon was associated with long-term mortality (<i>p</i> = 0.021) in the cox regression analysis.</p><p><strong>Conclusions: </strong>In our cohort patients in the IVL + pMCS group were hemodynamically more stable which led to a lower rate of catecholamine usage. pMCS as a bailout strategy was associated with in-hospital death and the occurrence of the slow reflow phenomenon with all-cause mortality during follow-up.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1451229"},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Design-related bias in studies investigating diagnostic tests for venous thromboembolic diseases: a systematic review and meta-analysis.
IF 2.8 3区 医学
Frontiers in Cardiovascular Medicine Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI: 10.3389/fcvm.2024.1420000
Laura Boschetti, Henning Nilius, Hugo Ten Cate, Walter A Wuillemin, Livia Faes, Patrick M Bossuyt, Lucas M Bachmann, Michael Nagler
{"title":"Design-related bias in studies investigating diagnostic tests for venous thromboembolic diseases: a systematic review and meta-analysis.","authors":"Laura Boschetti, Henning Nilius, Hugo Ten Cate, Walter A Wuillemin, Livia Faes, Patrick M Bossuyt, Lucas M Bachmann, Michael Nagler","doi":"10.3389/fcvm.2024.1420000","DOIUrl":"10.3389/fcvm.2024.1420000","url":null,"abstract":"<p><strong>Background: </strong>Early detection and diagnosis of venous thromboembolism are vital for effective treatment. To what extent methodological shortcomings exist in studies of diagnostic tests and whether this affects published test performance is unknown.</p><p><strong>Objectives: </strong>We aimed to assess the methodological quality of studies evaluating diagnostic tests for venous thromboembolic diseases and quantify the direction and impact of design characteristics on diagnostic performance.</p><p><strong>Methods: </strong>We conducted a literature search using Medline and Embase databases for systematic reviews summarizing diagnostic accuracy studies for five target disorders associated with venous thromboembolism. The following data were extracted for each primary study: methodological characteristics, the risk of bias scored by the QUADAS QUADAS-2 instrument, and numbers of true-positives, true-negatives, false-positives, and false-negatives. In a meta-analysis, we compared diagnostic accuracy measures from studies unlikely to be biased with those likely to be biased.</p><p><strong>Results: </strong>Eighty-five systematic reviews comprising 1'818 primary studies were included. Adequate quality assessment tools were used in 43 systematic reviews only (51%). The risk of bias was estimated to be low for all items in 23% of the primary studies. A high or unclear risk of bias in particular domains of the QUADAS/QUADAS-2 tool was associated with marked differences in the reported sensitivity and specificity.</p><p><strong>Conclusions: </strong>Significant limitations in the methodological quality of studies assessing diagnostic tests for venous thromboembolic disorders exist, and studies at risk of bias are unlikely to report valid estimates of test performance. Established guidelines for evaluation of diagnostic tests should be more systematically adopted.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD 42021264912).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1420000"},"PeriodicalIF":2.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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